摘要
目的:探讨双能量CTA(DE-CTA)碘物质图定量参数与主动脉夹层(AD)分支血管缺血程度的相关性,并分析其对患者短期及中期预后的预测价值。方法:回顾性纳入80例AD患者,均行DE-CTA检查,测量分支血管碘浓度(IC)、标准化碘浓度(NIC)及假腔IC,比较缺血组与非缺血组、预后不良组与预后良好组的参数差异,分析参数与缺血指标的相关性及预后影响因素。结果:缺血组分支血管IC、NIC低于非缺血组(P<0.001),假腔IC高于非缺血组(P<0.001);分支血管NIC与血肌酐(r=-0.632)、血乳酸(r=-0.589)呈负相关(P<0.001)。多因素Logistic回归显示,分支血管NIC降低(OR=0.032,P<0.001)和Stanford A型(OR=4.826,P=0.026)是预后不良的独立危险因素。结论:DE-CTA碘物质图定量参数(尤其是分支血管NIC)可有效评估AD分支血管缺血程度,并独立预测短期预后,为AD个体化诊疗提供影像学依据。
Objective:To investigate the correlation between the quantitative parameters of iodine substance map of dual-energy CTA(DE-CTA)and the degree of branch vessel ischemia in aortic dissection(AD),and to analyze its predictive value for short-term and medium-term prognosis of patients.Methods:Eighty patients with AD were retrospectively enrolled.DE-CTA examination was performed to measure the iodine concentration(IC)of branch vessels,standardized iodine concentration(NIC)and IC of false lumen.The differences of parameters between ischemic group and non-ischemic group,poor prognosis group and good prognosis group were compared.The correlation between the parameters and ischemic indexes and the influencing factors of prognosis were analyzed.Results:IC and NIC of branch vessels in ischemic group were significantly lower than those in non-ischemic group(P<0.001),the IC of the false lumen was higher than that of the non-ischemic group(P<0.001);The NIC of branch vessels was negatively correlated with serum creatinine(r=-0.632)and blood lactic acid(r=-0.589)(P<0.001).Multivariate Logistic regression showed that decreased NIC in branch vessels(OR=0.032,P<0.001)and Stanford type A(OR=4.826,P=0.026)were independent risk factors for poor prognosis.Conclusions:The quantitative parameters of DE-CTA iodine map,especially the NIC of branch vessels,can effectively evaluate the ischemic degree of AD branch vessels and independently predict the short-term prognosis,which provides imaging basis for the individualized diagnosis and treatment of AD.
作者
范炳全
Fan Bing-quan(CT Room,Nanyang First Peoples Hospital,Nanyang 473000,Henan,China)
关键词
主动脉夹层
双能量CT血管造影
碘物质图
分支血管缺血
预后
Aortic Dissection
Dual-Energy Computed Tomography Angiography
Iodine Material Map
Branch Vessel Ischemia
Prognosis
